Dental Sealants: Cavity Prevention for Children & Teens

Dental sealants are thin coatings that dentists apply to the chewing surfaces of your back teeth. These are primarily applied to the molars and premolars.

In this article, we’ll discuss how sealants work, their benefits, effectiveness, and cost.

How Do Dental Sealants Work?

Dental sealants create a thin layer of plastic to protect your teeth. The sealant prevents bacteria, plaque, and food particles from accumulating in the grooves of your teeth.

Sealants are an effective and safe way to prevent cavities. They can be applied to permanent or baby teeth.

In some cases, they can also be placed on teeth with staining or minor cavities, but cavity fillings are often recommended instead to prevent further decay.

At What Age Are Dental Sealants Most Effective?

Sealants are most effective for newly erupted permanent teeth. The earlier sealants are placed, the better.

A child’s first permanent molar (back tooth) erupts around age 6, and the second permanent molar erupts around age 12. However, teenagers (13+) are also good candidates for sealants.

However, some adults have deeper grooves in their back teeth, which puts them at a higher risk for tooth decay. In these situations, sealants may be recommended to address these hard-to-reach areas.

How are Sealants Placed on Teeth?

Sealants are made directly inside the mouth, not in a dental laboratory. Treatment is relatively fast and straightforward and is completed within one office visit.

The procedure consists of three steps:

• Step 1 — First, the dentist cleans the tooth to prepare it for treatment. They may use cotton rolls, suction, or other devices to dry the area.
• Step 2 — An acidic gel is placed into the grooves on the tooth. After 20 to 30 seconds, the etchant opens up tiny pores on the enamel surface to which the sealant bonds.
• Step 3 — The dentist rinses the acidic gel and dries the tooth again. They then place the sealant material into the grooves of your tooth. Lastly, they cure the sealant material (e.g., using a dental curing light for resin-based sealants, or allowing it to self-set if it is a chemically cured material).

What are the Benefits of Dental Sealants?

Dental sealants are safe, painless, noninvasive, and don’t dissolve in saliva. Most importantly, they can reduce the risk of tooth decay.

If you’re worried that dental sealants contain bisphenol A (BPA), you can rest assured that the amount found in sealants is considered non-toxic.

The highest level of BPA reported in saliva from tooth sealants is more than 50,000 times lower than the LD50 values reported for BPA. Toxic exposure to BPA from dental materials is low and poses no health risk.

Are Sealants Necessary?

According to the American Academy of Pediatric Dentistry, dentists recommend placing pit-and-fissure sealants on the biting surfaces of teeth in children because:

• Sealing the grooves of the teeth effectively helps prevent cavities.
• Sealants stop the spread of partially developed “microcavities” early on.
• Children between 6 and 11 years of age who do not have tooth sealants are about 3 times more likely to develop cavities.

How Much Do Dental Sealants Cost?

Without insurance, the cost of glass ionomer sealants is between $30 and $75 per tooth. Meanwhile, the price of composite resin sealants is around the same.

Since dental sealants are a preventive treatment, some dental insurance plans may cover part or all of the cost.

How Long Do Sealants Last?

Sealants can protect teeth from decay for up to 10 years. However, you’ll still need to visit the dentist to check for chipping or wear.

Sealants protect against 80 percent of cavities for 2 years. They will continue to protect against 50 percent of cavities for up to 4 years.

Dental sealants can be removed or replaced for a variety of reasons, such as:

• Improper placement
• Damaged sealants
• Damage from certain food and drinks
• Everyday wear
• Cavity under the sealants

What Are the Different Materials for Dental Sealants?

Sealants are separated into two categories, including glass ionomers and composite resins, based on their material composition and setting reactions:

Glass Ionomer

Glass ionomer sealants release fluoride to prevent tooth decay and strengthen enamel. Although these sealants may leak, the fluoride ions protect against leakage by helping to remineralize or protect the adjacent tooth enamel.

Eventually, fluoride release diminishes, but the initial exposure will have contributed to the enamel's health and strength. Glass ionomer materials also blend in with the color of natural teeth.

The main disadvantage of glass ionomer sealants is their lower retention rate than composite resin. This means they require more upkeep.

However, the fluoride release from glass ionomers offers a distinct advantage for cavity prevention, particularly in high-risk people or specific clinical settings. Consider that dentists typically use glass ionomer sealants on primary teeth (though they are also suitable for permanent teeth, especially where moisture control is difficult).

Composite Resin

Composite resin sealants are applied with a dental curing light and consist of a plastic compound that blends in with your natural tooth color. Composite resin is strong and can protect your teeth for a long time.

Composite resin sealants have a higher retention rate than glass ionomers and last 5 to 10 years. However, their main disadvantage is that they lack acid-base bonding properties and don’t release fluoride.

Finally, while conventional composite resins do not release fluoride, their excellent retention and marginal seal, when properly placed, contribute significantly to their high effectiveness in preventing cavities.